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The CREATE USER statement creates new MySQL accounts. An error occurs if you try to create an account that already exists. An account when first created has no privileges. To use CREATE USER, you must have the global CREATE USER privilege, or the INSERT privilege for the mysql database.
EXECUTE AS SELF is equivalent to EXECUTE AS user_name, where the specified user is the person creating or altering the module. The actual user ID of the person creating or modifying the modules is stored in the execute_as_principal_id column in the sys.sql_modules or sys.service_queues catalog view.